My 17-year-old son suffered a concussion while wrestling for his high school team. He suffered acute short-term memory loss and was brought to the ER. Upon reviewing his CT, they discovered he has a very large arachnoid cyst. He was transferred to another hospital under the care of a pediatric neurosurgeon where an MRI with contrast revealed "A large extra-axial CSF intensity cyst in the left anterior middle cranial fossa which extends superiorly into the left sylvian fissure compatible with an arachnoid cyst....it measures upwards of 7cm in AP dimension x 4.9 cm width x 7.4 cm in height. There is an element of associated mass effect. No bleed, intra-axial mass, or infarct."
We are following up with an ophthalmologist papilledema and evaluation of the visual fields. If this is not present, the neurosurgeon advises to follow up in 6 months with a repeat MRI. If it is present, he advises shunting.
I am reading a multitude of different approaches, but see mainly if there is a mass effect or the cyst is over a certain size, the recommendation is surgical intervention. Thoughts?